• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
bone and spine logo

Bone and Spine

Your Trusted Resource for Orthopedic Health Information

  • Home
  • About
  • Contact Us
  • Policies
  • Show Search
Hide Search
You are here: Home / Orthopedic Procedures / Dynamic Compression Plate Fixation Procedure

Dynamic Compression Plate Fixation Procedure

Dr Arun Pal Singh ·

Last Updated on February 6, 2025

A dynamic compression plate is a metallic plate used for the internal fixation of bone typically after fractures. It is designed so that it applies dynamic pressure between the fragments to be fixed so that a better fracture contact is gained.

Dynamic plates are meant for the fixation of long bone fractures. They can also be used in periprosthetic fractures. The dynamic compression plates are available in stainless steel and titanium.

Contents hide
1 Types of Dynamic Compression Plates
2 Principles of Dynamic Compression Plate Fixation
3 Using a Dynamic Compression Plates in Forearm Fractures
4 References

Types of Dynamic Compression Plates

A dynamic compression plate is available in many widths.

  • Broad DCP: The broadest one is used to fix larger bones like the tibia, and femur whereas the less broad plate is used in case of forearm fractures. It uses screws of 4.5 mm. It is also called broad DCP.
  • Narrow DCP: Another type with less width that also uses 4.5 screws is called narrow and is used in humerus.
  • Small DCP: It is even smaller in width and is meant for forearm bones or fibula. It uses 3.5 mm screws.
  • Mini plates: Used for metacarpals and phalanges. Use 2.7 or 2.0 mm screws.

A variant of dynamic compression plate, called DCP, low contact is more commonly used as this by its shape has minimum bone contact and thus preserves blood supply.

The under-surface of the DCP, by contact with bone, interferes with the blood supply of the underlying cortex.

Limited contact dynamic compression plate or LCDCP was an attempt to reduce the contact area because of its fluted undersurface.

The LCDCP has a fluted undersurface and minimizes the plate bone contact.

limited contact dynamic fracture plate

Principles of Dynamic Compression Plate Fixation

An effective plating should meet the following requirements.

  • Appropriate width and thickness for the given bone
  • Adequate and symmetric hold on either side of the fracture
  • Must be closely apposed to the contour of the bone.
  • Must neutralize all forces acting on the fracture i.e bending, compression, shear, and torque

Tension Band Principle

Bones are eccentrically loaded. That means one side is loaded more than the other. This affects to compressing one side and tendency to open the other side [compression and tension]. Hence when the plate is applied on the tension side, it turns the tension forces into compression forces bringing fracture fragments together provided the compression side is in contact too.

 

tension band plating
Illustration of tension band. The plate acts as a tension band when applied on the eccentric side of the bone and has enough contact on the opposite side to sustain cyclical loading
Image Credit: AO Foundation

Wherever possible plates should be put on the tension side of a fracture.

However, a plate may be positioned in compression Mode or neutralization mode. A plate in neutralization mode is just to counter bending,shear and rotational forces and not compression. The plate is used more like adjunct.

[Read about Plating Principles and Mode of Application]

Using a Dynamic Compression Plates in Forearm Fractures

Fractures of forearm bones [radius or ulna or both] require open reduction and internal fixation in most of adult cases. While the ulna is the subcutaneous bone which you can palpate from elbow to wrist, the radius is deep situated.

The radius can be approached either from the volar [on the side of the palm, Henry Approach] or from the dorsal [side opposite to the palm, Thompson approach] side.

In the proximal region [near to the elbow], the Thompson approach is preferred though it is ultimately the operating surgeon’s choice.

In the following images and text, I would take you through the dissection and fixation of a fracture of the proximal shaft of the radius which was opened using a dorsal approach and fixed with a dynamic compression plate. The patient also had an ulna fracture which was also fixed with DCP. The case in discussion is an adult male.

Preoperative X-ray

Following is the x-ray of the fractured forearm after injury and application of plaster splint. Both the bones are fractured and displaced. All displaced forearm fractures in adults require open reduction and internal fixation.

Fracture proximal radius
Fracture shaft of the radius bone in the proximal third region

Preoperative Details

Skin incision over the proximal and middle thirds of the radius along a line drawn from the center of the dorsum of the wrist to a point 1.5 cm anterior to the lateral humeral epicondyle. It is called Thompson approach after the scientist who propagated it.

 

Positioning orearm fir dorsal approach
Positioning forearm for dorsal approach

When the forearm is pronated, this line is nearly straight.

 

Dorsal Incision on forearm
Dorsal Incision

After the skin, the next layer is the fascia. Beneath that is a layer of muscles of the dorsal aspect. Interval for approaching the bone is developed between the extensor digitorum communis muscle and the extensor carpi radialis brevis, with each being retracted to the ulnar and radial sides.

 

Layer by layer dissection of tissues of forearm
Layer-by-layer dissection of tissues of the forearm

In the proximal third of the forearm, the supinator muscle would be exposed. Here we have exposed the shaft of the radius after incising the distal part of the supinator muscle.

Exposure of radial bone
Exposure of radial bone

Careful dissection of this muscle would expose the deep branch of the radial nerve [posterior interosseous nerve]. The nerve is carefully retracted.  The nerve is marked in the following diagram. Another method that does not involve exposure and retraction of the nerve is to lift the muscle free from the bone subperiosteally.

 

Posterior interosseous nerve exposed
Posterior interosseous nerve exposed

Fixation by compression plate and screws. The radial nerve is seen over the plate.

 

Dynamic compression plate fixation of the fracture
Dynamic compression plate fixation of the fracture

Following this fracture of the ulna was fixed with a dynamic compression plate as well.

Postoperative X-ray

Here is a postoperative x-ray. You will be able to appreciate the ulna fracture in this x-ray.

Postoperative xray of fracture radius and ulna
Postoperative x-ray of fracture radius and ulna

The fracture united well after 8 weeks of surgery.

References

  • Basic Principles of Plating, 2025 https://surgeryreference.aofoundation.org/orthopedic-trauma/adult-trauma/basic-technique/basic-principles-of-plating#compression-plates (accessed Feb 06, 2025) [Link]

Orthopedic Procedures This article has been medically reviewed by Dr. Arun Pal Singh, MBBS, MS (Orthopedics)

About Dr Arun Pal Singh

Dr. Arun Pal Singh is a practicing orthopedic surgeon with over 20 years of clinical experience in orthopedic surgery, specializing in trauma care, fracture management, and spine disorders.

BoneAndSpine.com is dedicated to providing structured, detailed, and clinically grounded orthopedic knowledge for medical students, healthcare professionals, patients and serious learners.
All the content is well researched, written by medical expert and regularly updated.

Read more....

Primary Sidebar

Know Your Author

Dr. Arun Pal Singh is an orthopedic surgeon with over 20 years of experience in trauma and spine care. He founded Bone & Spine to simplify medical knowledge for patients and professionals alike. Read More…

Explore Articles

Anatomy Anatomy Fractures Fractures Diseases Diseases Spine Disorders Spine Disorders Patient Guides Patient Guides Procedures Procedures
featured image for orthopedics traction

Orthopedic Traction – Principles, Types, and Uses

Traction is a fundamental concept in orthopedics for managing …

featured image of gower sign for segmenatal instability of lumbar spine

Clinical Tests for Lumbar Segmental Instability

Lumbar segmental instability may not always be visible on standard …

mesurement of scoliosis for braces

Braces for Scoliosis- Types, Uses and Results

Braces for scoliosis are recommended to prevent the scoliotic curve …

discogenic back pain

Discogenic Back Pain Causes, Diagnosis and Treatment

Discogenic back pain is a common cause of axial low back pain [the …

Elbow arthrodesis using internal fixation

Elbow Arthrodesis- Indications, Methods and Complications

Elbow arthrodesis refers to the surgical fusion of the elbow joint. It …

Popular articles

Carpal Bones or Bones of the carpus - wrist

Normal Wrist X-ray

Wrist x-rays are commonly done for wrist …

Congenital Pseudoarthrosis of clavicle

Congenital Pseudoarthrosis Of Clavicle

Congenital pseudoarthrosis of clavicle …

wound-dressings

Wound Dressings for wound Care

Wound care dressings and procedures aim …

Apert syndrome

Apert Syndrome Causes, Presentation and Treatment

First described as a syndrome by Apert …

Bone and Spine

© 2025 BoneAndSpine.com · All Rights Reserved
The content provided on BoneAndSpine.com is intended for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Read Disclaimer in detail.